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Surgical Endoscopy

, Volume 8, Issue 11, pp 1316–1323 | Cite as

Complications and recurrences associated with laparoscopic repair of groin hernias

A multi-institutional retrospective analysis
  • C. Tetik
  • M. E. Arregui
  • J. L. Dulucq
  • R. J. Fitzgibbons
  • M. E. Franklin
  • J. B. McKernan
  • R. D. Rosin
  • L. S. Schultz
  • F. K. Toy
Original Articles

Abstract

Although the laparoscopic technique is a new approach to groin hernia, it is becoming more widely accepted as an alternative to traditional open techniques. This study is a preliminary review of complications and recurrences.

A questionnaire specific for complications was sent to each investigator. From 12/89 to 4/93, 1,514 hernias were repaired; 119 (7.8%) were bilateral and 192 (12.7%) recurrent. There were 860 indirect, 560 direct, 43 pantaloon, 37 femoral, and 6 obturator hernias, and 8 were not specified; 553 were repaired using a transabdominal preperitoneal mesh technique (TAPP), 457 with a total extraperitoneal technique (TEP), 320 with intraperitoneal onlay mesh (IPOM), 102 by ring closure, and 82 involved plug and patch technique.

Eighteen intraoperative and 188 postoperative complications were seen. The total complication rate was 13.6%, of which 1.2% were intraoperative. Of the intraoperative complications, 12 were related to the laparoscopic technique, three were related to the hernia repair, and one was related to anesthesia. The rate of conversion to open was 0.8%. Of the postoperative complications, there were 95 local, 25 neurologic, 23 testicular, 23 urinary, 10 mesh, and 12 miscellaneous. There were 34 recurrences after the 1,514 hernia repairs (2.2%). The follow-up was reported in 828 patients for an average of 13 months. The recurrence rate varied drastically with the technique: A 22% recurrence rate after the plug and patch vs 3%, 2.2%, 0.7%, and 0.4% with the ring closure, IPOM, TAPP, and TEP, respectively.

Laparoscopic repair of groin hernia can be safely performed. Complications, mostly minor, diminish with experience. The recurrence rate is less with large mesh which is anchored.

Key words

Laparoscopic complications Inguinal hernia Laparoscopic herniorrhaphy 

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References

  1. 1.
    Selected data on hospitals and ambulatory surgical facilities. In: Schneidman DS (ed) Socio-economic factbook for surgery 1993. American College of Surgeons, Chicago, pp 37–54Google Scholar
  2. 2.
    Braeuer HL (1993) A new method of transabdominal endoscopic repair of inguinal and femoral hernias. 1993 Scientific Session and Postgraduate Course. March 31–April 3, 1993, Phoenix, ArizonaGoogle Scholar
  3. 3.
    Condon RE, Nyhus LM (1989) Complications of groin hernia. In: Nyphus L, Condon RE (eds) Hernia, 3rd ed. J.B. Lippincott Co., PhiladelphiaGoogle Scholar
  4. 4.
    Corbitt JD (1994) Transabdominal preperitoneal laparoscopic herniorrhaphy: method, complications and re-explorations. In: Arregui ME, Nagan RF (eds) Inguinal Hernia: Advances or Controversies? Radcliffe Medical Press Ltd., OxfordGoogle Scholar
  5. 5.
    Davies AH, Horrocks M (1989) Patient evaluation and complications of day-case herniorrhapy under local anasthetic. J R Coll Surg Edinb 34: 137–139Google Scholar
  6. 6.
    Deyo GA, Akamatsu TJ (1994) Laparoscopic inguinal herniorrhaphy under local anaesthetic. In: Arregui ME, Nagan RF (eds) Inguinal Hernia: Advances or Controversies? Radcliffe Medical Press Ltd., OxfordGoogle Scholar
  7. 7.
    Felix EL, Michas CA, McKnight RL Jr (1993) Laparoscopic herniorrhaphy—transabdominal preperitoneal floor repair. Presented at 1993 SAGES Scientific Session and Postgraduate Course, March 31–April 3, Phoenix, ArizonaGoogle Scholar
  8. 8.
    Felix EL, Michas CA, McKnight RL Jr (1994) Laparoscopic repair of recurrent groin hernias. In: Arregui ME, Nagan RF (eds) Inguinal Hernia: Advances or Controversies? Radcliffe Medical Press Ltd., OxfordGoogle Scholar
  9. 9.
    Finley RK, Miller SF, Jonese LM (1991) Elimination of urinary retention following inguinal herniorrhaphy. Am Surg 57: 486–489Google Scholar
  10. 10.
    Fitzgibbons R Jr, Annibali R, Litke B, et al (1993) A multicentered clinical trial on laparoscopic inguinal hernia repair. 1993 SAGES scientific Session and Postgraduate Course. March 31–April 3, 1993, Phoenix, ArizonaGoogle Scholar
  11. 11.
    Fong Y, Wantz GE (1992) Prevention of ischemic orchitis during inguinal hernioplasty. Surg Gynecol Obstet 174: 399–402Google Scholar
  12. 12.
    Gilbert AI (1994) Pitfalls and complications of inguinal hernia repair. In: Arregui ME, Nagan RF (eds) Inguinal Hernia: Advances or Controversies? Radcliffe Medical Press Ltd., OxfordGoogle Scholar
  13. 13.
    Hawasli A (1994) Laparoscopic inguinal herniorrhaphy with the mushroom plug: outcome and classification. In: Arregui ME, Nagan RF (eds) Inguinal Hernia: Advances or Controversies? Radcliffe Medical Press Ltd., OxfordGoogle Scholar
  14. 14.
    Katkhouda N (1994) Regional anesthesia in laparoscopic hernia repair. In: Arregui ME, Nagan RF (eds) Inguinal Hernia: Advances or Controversies? Radcliffe Medical Press Ltd., OxfordGoogle Scholar
  15. 15.
    MacFadyen BV Jr (1994) Laparoscopic inguinal herniorrhaphy: complications and pitfalls. In: Arregui ME, Nagan RF (eds) Inguinal Hernia: Advances or Controversies? Radcliffe Medical Press Ltd., OxfordGoogle Scholar
  16. 16.
    Newman L III, Eubanks WS, Mason E, Duncan T (1994) Laparoscopic herniorrhaphy—a review of our first 200 cases. In: Arregui ME, Nagan RF (eds) Inguinal Hernia: Advances or Controversies? Radcliffe Medical Press Ltd., OxfordGoogle Scholar
  17. 17.
    Olgin H, Seid AS, Doug T (1994) Laparoscopic herniorrhaphy—transabdominal preperitoneal floor repair. In: Arregui ME, Nagan RF (eds) Inguinal Hernia: Advances or Controversies? Radcliffe Medical Press Ltd., OxfordGoogle Scholar
  18. 18.
    Phillips EH, Carroll BJ, Fallas MJ, Arregui ME, Corbitt J Jr, Fitzgibbons RJ Jr, Pietrafita J, Sewell RW, Seid AS, Schultz LS, Toy FK, Waddell RL (1994) Reasons for recurrence following laparoscopic hernioplasty. In: Arregui ME, Nagan RF (eds) Inguinal Hernia: Advances or Controversies? Radcliffe Medical Press Ltd., OxfordGoogle Scholar
  19. 19.
    Pollak R, Nyhus L (1983) Complications of groin hernia repair. Surg Clin North Am 63:6: 1363–1371Google Scholar
  20. 20.
    Pritchard TJ, Bloom AD, Zollinger RM Jr (1991) Pitfalls in ambulatory treatment of inguinal hernias in adults. Surg Clin North Am 71:6; 1353–1362Google Scholar
  21. 21.
    Rutkow IR, Robbins A (1993) Demographic, classificatory, and socioeconomic aspects of hernia repair in the United States. Surg Clin North Am 73:3: 413–426Google Scholar
  22. 22.
    Rydell WB Jr (1963) Inguinal and femoral hernias. Arch Surg 87: 499Google Scholar
  23. 23.
    Seid AS (1994) Prosthetic biomaterials in hernia repair. In: Arregui ME, Nagan RF (eds) Inguinal Hernia: Advances or Controversies? Radcliffe Medical Press Ltd., OxfordGoogle Scholar
  24. 24.
    Taylor RS, Leopold PW, Loh A (1994) Improved patient well-being following laparoscopic inguinal hernia repair—the St. George's experience. In: Arregui ME, Nagan RF (eds) Inguinal Hernia: Advances or Controversies? Radcliffe Medical Press Ltd., OxfordGoogle Scholar
  25. 25.
    Theobald DR, Mack P, Kee SG, Wong WK, Ooi PJ (1993) Laparoscopic inguinal herniorrhaphy with preperitoneal tension-free polypropylene mesh repair. SAGES scientific Session and Postgraduate Course. May 31–April 3, 1993, Phoenix, ArizonaGoogle Scholar
  26. 26.
    Tran VK, Putz T, Rohde H (1992) A randomized controlled trial for inguinal hernia repair to compare the Shouldice and the Bassini-Kirschner operation. Int Surg 77: 135–137Google Scholar
  27. 27.
    van Steensel CJ, Weidema WF (1994) Laparoscopic inguinal hernia repair without fixation of the prosthesis. In: Arregui ME, Nagan RF (eds) Inguinal Hernia: Advances or Controversies? Radcliffe Medical Press Ltd., OxfordGoogle Scholar

Copyright information

© Springer-Verlag New York Inc 1994

Authors and Affiliations

  • C. Tetik
    • 1
  • M. E. Arregui
    • 1
  • J. L. Dulucq
    • 2
  • R. J. Fitzgibbons
    • 3
  • M. E. Franklin
    • 4
  • J. B. McKernan
    • 5
  • R. D. Rosin
    • 6
  • L. S. Schultz
    • 7
  • F. K. Toy
    • 8
  1. 1.Department of SurgerySt. Vincent Hospital and Health Care CenterIndianapolisUSA
  2. 2.Hopitale BagatelleTalence CedexFrance
  3. 3.School of Medicine, Department of SurgeryCreighton UniversityOmahaUSA
  4. 4.Health Science CenterUniversity of TexasSan AntonioUSA
  5. 5.Metropolitan Hospital & Marietta Surgery CenterMariettaUSA
  6. 6.St. Mary's HospitalLondonUK
  7. 7.Abbott Northwestern HospitalMinneapolisUSA
  8. 8.Nanticoke Memorial HospitalSeafordUSA

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